News Briefs
✦ Despite care utilization patterns rising closer to normal levels in the third quarter of 2020, adjusted earnings per share (EPS) for UnitedHealth Group fell 10% year-over-year to $3.51 as the company undertook ...
2021 Landscape Presents Myriad Choices, Benefits in MA
With its annual release of the so-called landscape files for the Medicare Advantage and Part D programs, CMS on Sept. 24 estimated that enrollment in MA will jump 10% to an “all-time high” of 26.9 million benefi...
Timing, Channel Optimization Are Keys to 2021 AEP Marketing
A presidential election is a known disruptor to Medicare marketing campaigns, which for the 2021 Annual Election Period (AEP) began on Oct. 1, and insurers and their broker partners this election cycle face the dual...
As Election Day Nears, Health Care Outlook Favors Payers
Although health care was a motivating factor for many voters in the 2018 midterm elections, the politicization of the COVID-19 pandemic and a lack of agreement within the Democratic and Republican parties on future ...
2019 Program Audits Reflect Continued Improvement
CMS’s latest overview of program audits showed continued improvement among Medicare Advantage and Part D organizations, with the average overall audit score dropping from 1.03 in 2018 to 0.77 in 2019. Scores impro...
News Briefs
✦ Molina Healthcare, Inc. on Sept. 29 said it entered into a definitive agreement to acquire substantially all of the assets of New York Medicaid managed care organization Affinity Health Plan for approximately $...
Curious Cases of Eric Johnson Trouble Pa. Blues Insurer
In a development that has some actuaries scratching their heads, the U.S. Attorney’s Office for the Eastern District of Pennsylvania on Sept. 3 unveiled a settlement with two Medicare Advantage plan subsidiaries o...
CMS’s Early Release of Advance Notice Cements RAPS Phaseout
In a surprise move aimed at giving some clarity to Medicare Advantage and Part D plans already thinking about their 2022 plan bids, CMS on Sept. 14 released Part 1 of the 2022 Advance Notice. But the items in the no...
Safety Net Plans Seek ‘Hold Harmless’ Policies From CMS
As the COVID-19 pandemic continues to shake up the health care system — and disproportionately impact vulnerable patients such as dual eligibles enrolled in Medicare-Medicaid Plans (MMPs) or Special Needs Plans (S...
Tenn. Blues Plan Gives PCPs High Marks for Quality
For the fifth year in a row, BlueCross BlueShield of Tennessee (BCBST) recently celebrated the achievements of hundreds of high-performing primary care physicians in its PPO network. The provider engagement effort i...